Transcript Functional Technique Part 2 Cervical & Lumbar Spine Stephen Tyreman PhD MA DO.

Functional Technique
Part 2
Cervical & Lumbar Spine
Stephen Tyreman PhD MA DO
Guidelines for Treatment
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The initial introduction of motion in any one
elementary direction is small, with minimal
forces applied
Motion directions are toward a sense of
immediately increasing ease; this response is
manifested by a decreasing sense of resistanceto-pressure at the fingers monitoring the
response at the tense dysfunctional segment.
(At the same time, motions are away from the
opposing direction in which increasing
resistance is encountered.)
Guidelines cont. 2
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Single elements of rotary and translatory directions
are combined, effecting the control of an eventual
smooth torsion arc for body movement. The order of
introduction of these elements is not important.
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The final step of the functional procedure involves
request for a specific direction of active respiration,
whichever direction (inhalation or exhalation)
contributes further to the increasing ease. For
example, if inhalation, the request is for the subject to
take a deep breath slowly, and hold briefly.
Guidelines
cont.
3
• This respiratory interval, adding to a continuous
feedback of decreasing resistance, allows the
operator to actively finalise the combination of
translatory and rotary elements most appropriate to
reach the objective of a sense of release of tissue
tension at the fingertips monitoring the dysfunctional
segment.
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The release of restraint in the motor mechanism
allows the return to midline resting, unobstructed by
any of the sense of resistance previously
encountered in the return direction.
Cervical diagnosis
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Patient sitting
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Scan tissues
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Motion testing
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Superficial & Deep
sidebending or rotation to the same side
Patient supine (Head over end of table)
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Motion testing
Cervical treatment
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Axial movements
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Side-bending left/right
Rotation left/right
Translatory movements
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Flexion/extension
Antero-posterior shift / P-A shift
Lateral right shift / lateral left shift
Caudad shift (compression) / Cranial shift (traction)
Respiration
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Inhalation / exhalation
Lumbar Spine
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Diagnosis
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Standing & sitting
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Scanning
Percussion
Motion testing (also test supine)
Treatment
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Sitting, sidelying, prone and supine
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Position according to diagnostic findings
Treatment of thoracic & lumbar spine sidelying
• Position in accordance with examination
findings
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Lying on right side entails sidebending left
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Think about relative position of hips and
shoulders
• Add additional components until lesion is
corrected
•Position in accordance with examination
Treatment of lumbar spine prone & supine
findings
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Use elbows supine to elevate shoulders
Use pillow prone to elevate hips or
shoulders
•Add additional components until lesion is
corrected
Physiological theory
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Explanation of Functional Technique depends on a
number of assumptions
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Nervous system organised around reflexes
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cybernetic control
Nervous system is not hard-wired
Nervous system is adaptable
Maladaptation (inappropriate physiology rather than
pathology)
Compliance
Compliance 2
Motor Control
Spindle Control
Muscle Spindle
MS system as an expression of human
behaviour
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Human behaviour is the final pathway of a number of
events:
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volitional commands
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social and psychological ‘norms’
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physical actions including their physiological support
activities we take for granted
expectations
innate physiological reflexes
Human
Behaviour